非离子型冠脉造影剂致急性严重过敏样反应的病例分析.pdfVIP

中国药物警戒第7 卷第5 期 2010~5 月 2010, Vo 1. 7, NO.5 中图分类号:R981.1 jR994.11 文献标识码:A 文章编号:1672-8629(2010)05-0281 -05 非离子型冠脉逅影剂致急性严撞过敏样反应的病例分析 费荣徐被杨跃进蹦爽李…石， (北京协和医学院中国~学科学院阜外心血管病医院卫生部心血管药物临床 研究熏点实验室，北京 1仰037) 摘嚣:目的对非离子型置若脉造影荆引起的急性严摸过敏样反应进行总结和分析。方法剧颐总结2007 年 12 月茧 2(朋年12 月在我院进行冠状动脉造影和/或介入治疗的24314 例患者，对发生冠脉造影剂引起的急性严重过敏 样反应的病例进行研究，分析其l临床特点。结果 9 例患者在接受非离子裂础造影剂血管内也射后 1 小时之内发生 严重过敏样反应，发生率 0.037% ，其l临床主要表现为血压突然降低，伴习之间程度的心律失常，及真他系统的伴随症 状。给予吸辑、朴液以及大剂量应用升压药物(尤其是肾上腺素)和糖皮质激素等治疗可有效矮解症状。结论非离子 型冠脉造影剂在l 临床应用中总的安~性良好，但在应用过程中应重视急性严重过敏样反应的识别与处理。 关键词:非离子现冠脉造影弗IJ; 急性严宽过敏样反应;分析 Analysis of Acute Severe Anaphylaxis Cases of Nonionic Coronary Contrast Media LOU Ying XU Bo YA!.叫GYue寸inX皿 Shuang LIYi叮hi (Key LaboratoI) ofClinical Trial Research in Cardiovascular Dru段， Mirústty of Health, Chinese Academy of Medical Science Pekíng Union Medical College Fu Wai Hospital Beijing 100037,China) Abstract: 0同ective To summarize and analyze acute severe anaphylactoid reaction cωes of nonionic corona巧 contr:ωt media during coronary an♂ography andJor percutaneous coronary intervention. Methods We retrospectively evaluated the outcomes of 24 314 patienωundergoing coron衍y angiography and/or perωtaneons coronary inter- vention in our hospital 企om December 2007 to December 2009 , and analyzed the cases with acute severe anaphy- lactoid reactions to nonionic contrast media. Results 9 patients exhibited severe anaphylactoid reactions to nonionic con忧郁t media , which typically occured within 1 hour a丘er intravascular injection.The incidence is about 0.037%. The main symptom of severe 则phylactoid reactionsωnonionic contrast media was s悖ùfìcantly lower blo叫 pre部町， wíth various degree of arrhythmia, accompanied by symptorns of other systerns. Oxygen, rehydration, and application of high … dose boost drugs(especially epinephrine) and corticosteroids were effective methods of treatment. Conclusion Nonionic con衍ast medi